AANP Responds to VA Plan for Independent Advanced Practice RNs

Cindy Cooke, DNP, FNP-C

July 06, 2016

To the Editor:

I am writing in response to a Medscape Medical News article published May 25, "VA Plan for Independent Advanced Practice RNs Riles Physicians."

The physician lobby is fighting hard against a proposal by the US Department of Veterans Affairs (VA) that would give veterans direct access to advanced practice registered nurses (APRNs) in our nation's veterans' facilities, absent so-called physician oversight. Rightly, this rule is focused on addressing the needs of veterans and a fatal flaw in our VA health system: egregious wait times that have caused veterans with urgent healthcare needs to wait as long as 6 months for healthcare and, in some tragic cases, to die waiting for care.

The opponents have sought to win public support by suggesting that the proposed rule, giving APRNs authority to practice autonomous of physician oversight, would somehow reduce veterans' quality of care. This suggestion flies in the face of countless news reports that have chronicled the vast shortfalls of an outdated system of understaffed, physician-led care in our nation's VA facilities.

APRNs include highly trained nurse practitioners (NPs), who are already authorized to practice autonomously in 21 states and the District of Columbia. The proposal would allow veterans in all 50 states that same level of access nationwide. More than 70 members of Congress have cosponsored legislation endorsing a similar measure.

NPs hold advanced degrees and national certification, and they offer years of clinical experience to their patients. This education and training is significant, exceeding their preparation as RNs and uniquely qualifying NPs for the clinical responsibilities of diagnosis, management of treatment plans, and prescribing. The proposal would allow veterans in all 50 states the same level of access nationwide.

Moreover, NPs hold a more than 50-year track record of providing safe, effective, patient-centered care to all patients, including our nation's veterans. Decades of healthcare data should make it obvious that NPs have the skills and experience to deliver excellent patient care, and that their patient health outcomes match or exceed that of their physician counterparts.

The VA is right to bring the skills and expertise of its 4800 NPs directly to our nation's veterans, and honor our heroes with the high-quality healthcare they have earned.

Cindy Cooke, DNP, FNP-C
American Association of Nurse Practitioners


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